The following is a case study involving a young pregnant women by the name of Kim. Kim is 17 years old and presenting to the local hospital for antenatal care. Please see appendix 1 for more information regarding Kim’s situation. This case study will identify risk factors that make Kim’s pregnancy complex and examine aspects of antenatal, intrapartum and postpartum care provided to Kim, and later in the case study, her infant. Care options for Kim will be based on evidence-based practice. Kim will be cared for by a multidisciplinary team, however, this case study is written from the perspective of a Registered Midwife employed within the Queensland public health system. Please note that Kim will see an obstetrician as per hospital protocol
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Strong social support acts as a buffer for stress, improves quality of life and leads to better health outcomes and fewer pregnancy complications for mother and baby (Shishehgar et al., 2013; Elsenbruch et al., 2007). The midwife’s objective here is to manage and hopefully improve Kim’s risk factor of poor social support by increasing her level of social support (Shishehgar et al., 2013). To do this the midwife will encourage Kim to participate in a group model of antenatal care. Group models of care are ideally suited to pregnant teens as the components; antenatal care, education and support, can be easily adapted to the developmental needs of the attending adolescents (Grady & Bloom, 2004). Group models of care have been shown to reduce social isolation due to provision of social support and the development of relationships that occur naturally within the group environment (Teate, Leap, Rising & Homer, 2011; Klima, 2003). Klima (2003) explains that the support system gained through group antenatal care is especially beneficial for pregnant teens, like Kim, who lack social support from their partner and family members. Other positive aspects resulting from group antenatal care that may be beneficial to Kim include reduced risk of preterm birth and low birth weight and reduced risk of postnatal depression (Teate et al., …show more content…
Controlling blood glucose levels becomes more difficult during pregnancy for women with type 1 diabetes (Thorogood & Donaldson, 2010). This is due to changes in the way that carbohydrates are metabolised during pregnancy and also means that the woman’s insulin requirements will change as dosage is calculated according to her blood glucose level (Thorogood & Donaldson, 2010; Robson, Marshall, Doughty & McLean, 2014). Ideally, women with type 1 diabetes should seek pre-conception care as the level of risk for pregnancy related complications is influenced by the woman’s health just prior to conception and within the first trimester of the pregnancy (Magon & Chauhan, 2012; Robson et al., 2014; Thorogood & Donaldson, 2010). The purpose of pre-conception care is to screen for and assess existing diabetes related conditions, review current medications, recommend folic acid supplementation, encourage smoking and alcohol cessation if required and educate women regarding possible pregnancy complications and the importance of self-care (Robson et al., 2014; Thorogood & Donaldson, 2010). Pre-conception care has also been shown to reduce the risk of miscarriage and pregnancy complications (Thorogood & Donaldson, 2010). Maternal risks during pregnancy due to type 1 diabetes include miscarriage, depression, pre-eclampsia, peripheral vascular disease, cardiovascular disease, nephropathy, diabetic ketoacidosis,
Strong social support acts as a buffer for stress, improves quality of life and leads to better health outcomes and fewer pregnancy complications for mother and baby (Shishehgar et al., 2013; Elsenbruch et al., 2007). The midwife’s objective here is to manage and hopefully improve Kim’s risk factor of poor social support by increasing her level of social support (Shishehgar et al., 2013). To do this the midwife will encourage Kim to participate in a group model of antenatal care. Group models of care are ideally suited to pregnant teens as the components; antenatal care, education and support, can be easily adapted to the developmental needs of the attending adolescents (Grady & Bloom, 2004). Group models of care have been shown to reduce social isolation due to provision of social support and the development of relationships that occur naturally within the group environment (Teate, Leap, Rising & Homer, 2011; Klima, 2003). Klima (2003) explains that the support system gained through group antenatal care is especially beneficial for pregnant teens, like Kim, who lack social support from their partner and family members. Other positive aspects resulting from group antenatal care that may be beneficial to Kim include reduced risk of preterm birth and low birth weight and reduced risk of postnatal depression (Teate et al., …show more content…
Controlling blood glucose levels becomes more difficult during pregnancy for women with type 1 diabetes (Thorogood & Donaldson, 2010). This is due to changes in the way that carbohydrates are metabolised during pregnancy and also means that the woman’s insulin requirements will change as dosage is calculated according to her blood glucose level (Thorogood & Donaldson, 2010; Robson, Marshall, Doughty & McLean, 2014). Ideally, women with type 1 diabetes should seek pre-conception care as the level of risk for pregnancy related complications is influenced by the woman’s health just prior to conception and within the first trimester of the pregnancy (Magon & Chauhan, 2012; Robson et al., 2014; Thorogood & Donaldson, 2010). The purpose of pre-conception care is to screen for and assess existing diabetes related conditions, review current medications, recommend folic acid supplementation, encourage smoking and alcohol cessation if required and educate women regarding possible pregnancy complications and the importance of self-care (Robson et al., 2014; Thorogood & Donaldson, 2010). Pre-conception care has also been shown to reduce the risk of miscarriage and pregnancy complications (Thorogood & Donaldson, 2010). Maternal risks during pregnancy due to type 1 diabetes include miscarriage, depression, pre-eclampsia, peripheral vascular disease, cardiovascular disease, nephropathy, diabetic ketoacidosis,